Nature against nurture: calcification in the right thalamus in a young man with anorexia nervosa and obsessive-compulsive personality disorder.
This report describes the case of a young man with a large calcification in the right thalamus that was first diagnosed at 9 years of age. Case history reveals specific eating rituals and other obsessive-compulsive personality traits during the patient's childhood and adolescence, fulfilling diagnostic criteria of obsessive-compulsive personality disorder. After a critical life event the patient develops anorexia nervosa. We suggest that our case and further literature provide evidence for an involvement of specific thalamic structures, such as the dorsomedial nucleus, in the development of anorexia nervosa. Furthermore, the treatment of the patient by a combined psychotherapeutic and pharmacotherapeutic approach is described. We focus on the beneficial effect of the atypical antipsychotic olanzapine, which can induce weight gain by an increase of leptin levels.
Conrad
Rupert
R
Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Bonn, Germany. Rupert.Conrad@ukb.uni-bonn.de
Wegener
Ingo
I
Geiser
Franziska
F
Imbierowicz
Katrin
K
Liedtke
Reinhard
R
D000328:Adult; D000856:Anorexia Nervosa / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D001569:Benzodiazepines / Q000627:therapeutic use; D002114:Calcinosis / Q000175:diagnosis* / Q000503:physiopathology; D003131:Combined Modality Therapy; D004292:Dominance, Cerebral / Q000502:physiology; D006801:Humans; D008016:Life Change Events; D008297:Male; D020645:Mediodorsal Thalamic Nucleus / Q000503:physiopathology; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use; D000078785:Mirtazapine; D009771:Obsessive-Compulsive Disorder / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D000077152:Olanzapine; D017374:Paroxetine / Q000627:therapeutic use; D011613:Psychotherapy; D013786:Thalamic Diseases / Q000175:diagnosis* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
D001569:Benzodiazepines; D008803:Mianserin; D017374:Paroxetine; D000078785:Mirtazapine; D000077152:Olanzapine